FODMAP ANTIDOTES July 2023
THE BACKSTORY
The acronym FODMAP flew on to our scene when we were reading a medical research article back in 2014 providing an explanation for the too frequent indigestion and bloating, we both were experiencing. Like many people, we struggled to understand why we didn’t ever feel quite right and had traveled part way down the gluten-free path in hopes of improving our baseline sense of wellbeing. Avoiding gluten seemed help some, but it wasn’t the answer. Lucky for us, learning to navigate around the correct FODMAP carbohydrates for each of us was the answer.
FODMAP is the acronym for fermentable oligiosaccharides, disaccharides, monosaccharides and polyols, which doesn’t tell most of us anything useful. FODMAP are short-chained carbohydrates that are malabsorbed in some people, which again, leaves most of us wondering what this is really about. They are naturally occurring sugars, a part of food, and are in foods that are ‘good for you.’ However, if they make you sick, that food isn’t good for YOU.
A deep dive is required to make the notion of FODMAP operational for each of us, but many of us with nagging GI issues are willing to take the time to know more. To do that most easily, I highly recommend using the Monash University resources available at www.monashfodmap.com to educate yourself about the subject. I learned most of what I know about FODMAP from them back in 2014. Since then, they’ve greatly expanded their services, including an online tutorial, and started charging for their app. I still regularly use the Food Guide in their great app to identify problem foods for me.
Be forewarned however, that Monash accumulates its data on food composition the old-fashioned way, by individually testing foods in a laboratory, and consequently, their information changes. They retest foods; more finely differentiate compositions between varieties; and report separately on the stems and heads of foods like broccoli, over time. Consequentially, conclusions you have drawn from their Food Guide might become obsolete. Other sources may contradict Monash University’s results. It’s an evolving science, not an exact one, and you must be the final judge about what foods affect you. And course, as they are improving their reference material, your sophistication with understanding FODMAP will progress and be refined.
Because of multiple FODMAP intolerances, I have an extremely limited diet. In 2014, I had to abandon my vegetarian diet and switched to a meat-based, ketogenic diet. Only then, could I consume enough protein to fend off sarcopenia, which is age-related muscle loss. I’ve been on a low carbohydrate, low FODMAP, keto diet for 9 years and am convinced it’s the best diet for my gut and lifestyle.
FODMAP ANTIDOTES
Elimination Diets
The foundational strategy for ending GI upset from FODMAP intolerances is an elimination diet. With it, one systematically removes foods from your diet until you’ve ousted all the irritants and your gut can heal. Once you have no more indigestion, then you slowly start adding foods back onto your plate to refine your understanding of what you can and cannot eat.
The process includes identifying which of the 6 carbohydrates are a source of indigestion for you and then fiddling with your diet to determine how much, if any, of the irritating carbohydrates you can eat a day. It is a slow process and involves a lot of trial and error, but it works.
Enzymes
A Different Approach
The 2nd approach to calming indigestion from FODMAP intolerance is using specific enzymes to breakdown the target FODMAP while you eat your food. You still benefit from knowing which carbs and foods are the culprits for you. Until recently, only 2 of the 6 FODMAP had an enzyme antidote and now there is a 3rd, though 2 more may be on the way. I primarily rely on eliminating troublesome foods to control my indigestion and only this summer, have I used an enzyme as an antidote. Usually when “-ase” is the last syllable in a word, the word is the name of an enzyme.
Lactase Breaks Down Lactose
Lactose is one of the FODMAP but a lactose intolerance is relatively easy to adjust to because lactose-free dairy products are readily available. Additionally, bacteria pre-digest almost all the milk lactose during the fermentation of hard cheeses, so many lactose intolerant individuals can tolerate the amount of lactose in hard cheeses.
Tablets containing lactase, the enzyme that breaks down lactose, that can be taken with dairy products, work well. If dodging lactose by using lactose-free products or lactase tablets doesn’t remedy your intolerance of dairy products, it’s time to determine if you are intolerant of either or both milk proteins, whey and casein. (I am intolerant of lactose, whey, and casein, so no dairy products for me.)
Alpha-Galactosidase Breaks Down GOS
GOS (galacto-oligosaccharide) is one of 2 oligosaccharides identified as a FODMAP and is primarily found in dried beans and some vegetables. GOS has a single antidote, the enzyme alpha-galactosidase, which, like lactase, is readily available.
Fructan Hydrolase & Inulase Break Down Fructans
Two different enzymes are now available to break-down a 3rd FODMAP, fructans, and it’s a game changer for me. Fructans seems like they are in everything I want to eat: garlic, onions, cauliflower, wheat, most nuts—the list goes on and on. I also struggle with uncontrolled hypertension and some of the foods recommended for treating it, like cranberries, are high in fructans, hence my experimentation with the new enzyme products. The Fodzyme brand has labeled their anti-fructans product as Fructan hydrolase, and the Fodmate brand calls their enzyme inulinase.
THE BACKSTORY
The acronym FODMAP flew on to our scene when we were reading a medical research article back in 2014 providing an explanation for the too frequent indigestion and bloating, we both were experiencing. Like many people, we struggled to understand why we didn’t ever feel quite right and had traveled part way down the gluten-free path in hopes of improving our baseline sense of wellbeing. Avoiding gluten seemed help some, but it wasn’t the answer. Lucky for us, learning to navigate around the correct FODMAP carbohydrates for each of us was the answer.
FODMAP is the acronym for fermentable oligiosaccharides, disaccharides, monosaccharides and polyols, which doesn’t tell most of us anything useful. FODMAP are short-chained carbohydrates that are malabsorbed in some people, which again, leaves most of us wondering what this is really about. They are naturally occurring sugars, a part of food, and are in foods that are ‘good for you.’ However, if they make you sick, that food isn’t good for YOU.
A deep dive is required to make the notion of FODMAP operational for each of us, but many of us with nagging GI issues are willing to take the time to know more. To do that most easily, I highly recommend using the Monash University resources available at www.monashfodmap.com to educate yourself about the subject. I learned most of what I know about FODMAP from them back in 2014. Since then, they’ve greatly expanded their services, including an online tutorial, and started charging for their app. I still regularly use the Food Guide in their great app to identify problem foods for me.
Be forewarned however, that Monash accumulates its data on food composition the old-fashioned way, by individually testing foods in a laboratory, and consequently, their information changes. They retest foods; more finely differentiate compositions between varieties; and report separately on the stems and heads of foods like broccoli, over time. Consequentially, conclusions you have drawn from their Food Guide might become obsolete. Other sources may contradict Monash University’s results. It’s an evolving science, not an exact one, and you must be the final judge about what foods affect you. And course, as they are improving their reference material, your sophistication with understanding FODMAP will progress and be refined.
Because of multiple FODMAP intolerances, I have an extremely limited diet. In 2014, I had to abandon my vegetarian diet and switched to a meat-based, ketogenic diet. Only then, could I consume enough protein to fend off sarcopenia, which is age-related muscle loss. I’ve been on a low carbohydrate, low FODMAP, keto diet for 9 years and am convinced it’s the best diet for my gut and lifestyle.
FODMAP ANTIDOTES
Elimination Diets
The foundational strategy for ending GI upset from FODMAP intolerances is an elimination diet. With it, one systematically removes foods from your diet until you’ve ousted all the irritants and your gut can heal. Once you have no more indigestion, then you slowly start adding foods back onto your plate to refine your understanding of what you can and cannot eat.
The process includes identifying which of the 6 carbohydrates are a source of indigestion for you and then fiddling with your diet to determine how much, if any, of the irritating carbohydrates you can eat a day. It is a slow process and involves a lot of trial and error, but it works.
Enzymes
A Different Approach
The 2nd approach to calming indigestion from FODMAP intolerance is using specific enzymes to breakdown the target FODMAP while you eat your food. You still benefit from knowing which carbs and foods are the culprits for you. Until recently, only 2 of the 6 FODMAP had an enzyme antidote and now there is a 3rd, though 2 more may be on the way. I primarily rely on eliminating troublesome foods to control my indigestion and only this summer, have I used an enzyme as an antidote. Usually when “-ase” is the last syllable in a word, the word is the name of an enzyme.
Lactase Breaks Down Lactose
Lactose is one of the FODMAP but a lactose intolerance is relatively easy to adjust to because lactose-free dairy products are readily available. Additionally, bacteria pre-digest almost all the milk lactose during the fermentation of hard cheeses, so many lactose intolerant individuals can tolerate the amount of lactose in hard cheeses.
Tablets containing lactase, the enzyme that breaks down lactose, that can be taken with dairy products, work well. If dodging lactose by using lactose-free products or lactase tablets doesn’t remedy your intolerance of dairy products, it’s time to determine if you are intolerant of either or both milk proteins, whey and casein. (I am intolerant of lactose, whey, and casein, so no dairy products for me.)
Alpha-Galactosidase Breaks Down GOS
GOS (galacto-oligosaccharide) is one of 2 oligosaccharides identified as a FODMAP and is primarily found in dried beans and some vegetables. GOS has a single antidote, the enzyme alpha-galactosidase, which, like lactase, is readily available.
Fructan Hydrolase & Inulase Break Down Fructans
Two different enzymes are now available to break-down a 3rd FODMAP, fructans, and it’s a game changer for me. Fructans seems like they are in everything I want to eat: garlic, onions, cauliflower, wheat, most nuts—the list goes on and on. I also struggle with uncontrolled hypertension and some of the foods recommended for treating it, like cranberries, are high in fructans, hence my experimentation with the new enzyme products. The Fodzyme brand has labeled their anti-fructans product as Fructan hydrolase, and the Fodmate brand calls their enzyme inulinase.
Anti-Fructans enzyme products.
Two other FODMAP are polyols: mannitol and sorbitol. They are a little less common in foods and easier to navigate around when eating. The manufacturer of Fodzyme teases us by saying they have developed the polyol antidote, but it isn’t on the market because it is still in the patent process.
Fructose
Fructose is the 6th of 6 FODMAP and, to the best of my knowledge, there is no ingestible antidote for its effects; reducing your intake or balancing it with your glucose consumption, are the only strategies for controlling its gut irritating effects.
Price & Product Details
Lactase
Lactase is a readily available antidote for lactose intolerance. Before I knew the proteins in dairy also upset my gut, I bought my lactase at Costco. Read the labels and compare products in pharmacies and grocery stores to select a product and then experiment to determine how much you need to consume with your favorite dairy products. A customary dose is 6,000-9,000 IU (international units).
For GOS
The least expensive alpha-galactosidase product I’ve found to break down GOS is Walmart’s Equate Brand for Gas and Bloating Prevention. Beano tablets are a bit more expensive and CVS Health’s Beanaid is even pricier. I happily bought the Equate brand with its high concentration of enzyme in tiny capsules in a little bottle. Not only was it budget priced, “small” is always a big selling point for us as travelers.
A comparison of retail product prices of this enzyme in Arizona in March 2023 is as follows:
..Walmart Equate brand: Gas and Bloating Prevention $6 for 100 capsules with 600 GALU each
..Walmart sourced Beano Gas Prevention and Relief, $25 for 150 tablets of 300 GALU
..CVS Health Beanaid $16 for 30 capsules with 300 GALU
..amazon.com has a mind-blowing panoply of simple & elaborate enzyme concoctions.
Monash University, my go-to source for FODMAP information, recommends 300 GALU with each serving, perhaps consuming 150 GALU before eating the GOS-containing food and the remaining 150 GALU when finished eating the GOS source.
I used one Equate capsule while ingesting my reconstituted beet powder that was the equivalent of 4 beets. I worked like a charm, even though I am intolerant of both fructans and GOS, both of which are in fresh beets. As is often the case with FODMAP intolerance, it requires a bit of trial and error to establish how much of an offending FODMAP you can tolerate. Likewise, using enzymes will require some experimentation to get the effect you need.
My success with the alpha-galactosidase capsules also boded well for re-introducing garbanzo and borlotti beans, as well as green and red lentils (but not Le Puy), to my diet. Borlotti’s are often on the store shelf in Italy. Beans such as red kidney beans, black beans, cannellini beans, and soy beans contain both GOS and fructans, so, like with the beets, will require experimentation to assess if I get enough GOS gas control with the enzyme capsules to digest them. Given my low-carb, keto diet, I won’t likely be in a hurry to risk gut upset by experimenting with with these beans but am delighted that readily available canned garbanzos and borlotti will be options for me for food emergencies when traveling.
A bit of trivia, complements of Wikipedia: the idea for Beano goes back to an essay submitted by Benjamin Franklin in the 1780’s. The Beano product was finally developed in 1990. The patent expired in 2014 and more than 4 dozen competing products were soon on the market.
Ironically, I started using Beano drops not long after it became available for my puzzling chronic GI distress and gas. It helped, but I eventually stopped using it because it wasn’t a decisive fix. Much to my surprise, in March 2023 when I began consuming beet juice and powder products as a possible treatment for my hypertension, I rediscovered Beano. After all these years, I understood why it had been of some help to me in the past, it was because it had been breaking down GOS. Since learning about FODMAP in 2014, I have dealt with my intolerance to GOS by avoiding foods containing this oligosaccharide.
Enzymes for Fructans
Compared to lactase and the GOS antidote, these anti-fructans products are wildly expensive. I’m still experimenting to determine the least amount of both products that I can use while retaining 100% prevention of fructans side-effects.
If you aren’t as price sensitive as I am and are in a hurry, just sprinkle the powder or pop the capsules according to the recommendations on the product labels to avoid an upset. Unfortunately, the enzymes are useless after your gut revolts to the fructans, so you’ll need to error on the long side when eating the irritating foods with the enzyme. I found both products to be effective, approximately equally so.
Here are my notes to myself on the 2 products, Fodzyme and Fodmate.
Fodzyme
Contains 24 mg enzyme/serving = 1/4 tsp = 0.75 g with dextrin, including
…sufficient fructan hydrolase to cover the average high fructans meal with 1/4 tsp = 1 scoop
…800+ GALU for GOS
…9000+ FCC units of lactase for lactose
For reconstituted beverages: mix Fodzyme powder with your powder (like dry cranberry or beetroot), add a little water, mix well, let stand 5”, ingest
Fructans hydrolase = glycoside hydrolase
As of July 2023, I use 0.4g/serving, measured on a jeweler’s scale (too fluffy to measure by scoop).
5 types of fructans, inulin = 1 type, is prebiotic dietary fiber, induces growth of microorganisms
Onions have 1/2 the fructans of garlic
$81.25/45 g jar; with discount + shipping $73,13, ships from US: Massachusetts
Caveat: BioSciences, the manufacturer of Fodzyme, frequently changes their pricing and the information available on their website. Some of the information in my above notes made in the late spring of ’23 can no longer be confirmed on their website. The price when I ordered was $81.45 for a precious jar of product appears to have dropped to $65 in July 2023. It appears that they now offer free shipping, which wasn’t the case when I ordered. I received an email in July 2023 indicating that their product could now be purchased on amazon.com. I find mention of it on amazon, but cannot bring up the product, perhaps because I am overseas. Go with what you see on their website, not my notes, if there is conflicting information.
Fodmate
$65 for 120 capsules or 60 servings, free delivery with Amazon
In addition to their anti-fructans enzyme, it includes lactase for lactose and alpha-galactosidase for GOS, like Fodzyme does.
Fodmate contains a “proprietary enzyme blend of Endo- and Exo-Inulinase”
Fodmate is sold in capsules, and they recommend popping a capsule when you eat offending foods (which is easy) but I open the Fodmate capsule and sprinkle the contents on my food. Fodzyme is a loose powder to be sprinkled and intuitively, Fodzyme’s seems to be a better strategy. The enzymes must latch on to the fructans compound embedded in the food, then chemically react with it, and the enzyme has a better chance of hitting the target if it’s not in a capsule.
Please share your experiences with me if you try either or both products. Thanks.
INTERESTED, BUT…
If part of you is saying “I really should give this low FODMAP thing a try…” and another part of you is pushing back because of the time and energy required, you can buy your way out of the conflict. There are now low FODMAP meal delivery options.
Modifyhealth.com offers 2 options: meal delivery and meal delivery + consultation. Either option allows you to start eating low FODMAP meals right away, beginning an elimination diet immediately. Doing so, gives your gut time to heal while you get organized for doing more yourself. Their prices are reasonable, but their meals don’t match my nutrition goals. Depending upon the meals you select, you might only get 1,000 calories per day. I routinely eat 2,500 calories, or more per day. Additionally, I am very persnickety about my protein intake with each meal and, as one would predict with their relatively low-calorie meals, the protein provided comes up short for me.
Epicured.com has similar low FODMAP products to those on modifyhealth.com and a quick look suggested theirs would also be low calorie and low protein by my standards. One could certainly use the meals from either company as a foundation and supplement them with inherently low FODMAP foods, like plain quinoa and fish or meat, to boost both the nutritional content and calories of their meals.